Provider Demographics
NPI:1588910822
Name:DILWORTH, JEREMI (IBCLC)
Entity type:Individual
Prefix:
First Name:JEREMI
Middle Name:
Last Name:DILWORTH
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:247 STOCKHAM AVE
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19067-1143
Mailing Address - Country:US
Mailing Address - Phone:484-769-2287
Mailing Address - Fax:
Practice Address - Street 1:247 STOCKHAM AVE
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:PA
Practice Address - Zip Code:19067-1143
Practice Address - Country:US
Practice Address - Phone:484-769-2287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA174N00000X174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN